What causes sharp stabbing pain on top of foot

Dorsal neuritis or neuralgia is a foot condition which results in burning, tingling, numbness, and sharp/shooting pain on the top part of your foot. This problem may occur with regular shoegear but also with more constrictive foot ware such as ski boots, climbing shoes, or skates. The cause of this painful problem is due to compression or impingement of a sensory nerve or nerve branch located on the dorsal (top) of your foot. Let’s go over some anatomy: The main nerves which innervate the skin of the dorsal foot (going from the inside to the outside part of the foot) are the: medial dorsal cutaneous nerve, intermediate dorsal cutaneous nerve, and sural nerve. Any one of these nerves may be afflicted, causing pain.

Causes:

One of the most common causes of dorsal neuritis/neuralgia is pressure from tight shoes. Over-tightening shoe laces or wearing shoes which are too small or shoes with limited toe box room can all cause compression of dorsal nerves. To avoid these problems, wear appropriately sized shoes, avoid shoes with firm tongues and pick shoes with padded tongues, and re-route laces by skipping eyelets so the laces do not cross the painful aspect of your foot. Nerve pain on the top of your foot can also be caused by a structural abnormality such as a bone spur or a cyst or other lesion which contributes pressure to an adjacent nerve.

Treatments:

Treatment options vary depending upon the root cause of the dorsal neuritis. As mentioned, shoegear changes can reduce symptoms. If a bone spur on the top of the foot is the culprit, padding may help but surgery may ultimately be indicated to remove the bone spur. Patients with a cyst may require aspiration of the fluid and/or steroid injection in order to shrink the cyst and alleviate symptoms. If this fails to work, surgery can be considered. In either case, non-invasive laser therapy may also be helpful.

If these uncomfortable symptoms sound familiar to you and have been present too long, please give us a call so we may help you.

Overview

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia).

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight.

Symptoms

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or when you get up from sitting.

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Causes

The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking.

Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the facia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.

Risk factors

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

  • Age. Plantar fasciitis is most common in people between the ages of 40 and 60.
  • Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
  • Foot mechanics. Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you're standing and can put added stress on the plantar fascia.
  • Obesity. Excess pounds put extra stress on your plantar fascia.
  • Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can be at increased risk of plantar fasciitis.

Complications

Ignoring plantar fasciitis can result in chronic heel pain that hinders your regular activities. You're likely to change your walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems.

Jan. 20, 2022

  1. Buchbinder R. Plantar fasciitis. https://www.uptodate.com/contents/search. Accessed Oct. 2, 2021.
  2. Plantar fasciitis. American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/conditions-treatments/heel/plantar-fasciitis. Accessed Oct. 2, 2021.
  3. Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs. Accessed Oct. 2, 2021.
  4. AskMayoExpert. Plantar fasciitis. Mayo Clinic; 2020.

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